Investigation of biomarker for intra-articular fibrosis after anterior cruciate reconstruction
| Project/Area Number |
19K18454
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 56020:Orthopedics-related
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| Research Institution | Tokyo Medical and Dental University |
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Principal Investigator |
Nakagawa Yusuke 東京医科歯科大学, 大学院医歯学総合研究科, 准教授 (60822666)
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| Project Period (FY) |
2019-04-01 – 2022-03-31
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| Project Status |
Completed (Fiscal Year 2021)
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| Budget Amount *help |
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2020: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2019: ¥2,600,000 (Direct Cost: ¥2,000,000、Indirect Cost: ¥600,000)
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| Keywords | 線維化 / 前十字靭帯損傷 / 炎症性サイトカイン / 関節液 / 前十字靱帯再建術 / 膝蓋下脂肪体線維化 / バイオマーカー / 前十字靭帯再建術 / 前十字靭帯再建再建術 / 関節内線維化 / 免疫細胞 |
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| Outline of Research at the Start |
目的は前十字靭帯（ACL）再建術後の膝蓋下脂肪体（IFP）線維化に関わるバイオマーカーを探索し、ACL再建術の成績不良例の患者を早期に検出し、早期に介入を行うことで治療成績の向上を目指す。先行研究から我々はIFP線維化のマーカーとして術後の関節液中の炎症性サイトカインと免疫細胞に注目した。本研究にて以下の事象を明らかにする。
「関節液中の炎症性サイトカイン、免疫細胞と術後3ヵ月のIFP 線維化の程度との関連」
そのためにACL再建術患者の術後3日目、21日目に関節液を採取し、炎症性サイトカイン濃度、免疫細胞分画を測定。術後3ヶ月でMRIによるIFP線維化の評価と、臨床成績、疼痛を評価する。
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| Outline of Final Research Achievements |
omplications after anterior cruciate ligament reconstruction (ACLR) includes intra-articular fibrosis leading to residual pain and delayed functional recovery. This study aimed to evaluate clinical outcomes and inflammatory cytokine levels in the synovial fluid of ACLR patients with or without severe IFP fibrosis. Patients were divided into two groups based on IFP fibrosis scoring. Synovial fluid was aspirated on the third or fourth postoperative day to measure inflammatory cytokines levels. Of the 36 patients included, 7 were allocated to the severe fibrosis group and 29 to the mild fibrosis group. Pain in the severe fibrosis group was greater and lower extension muscle strength than that in the mild fibrosis group. The severe fibrosis group demonstrated higher interleukin-1β, interleukin-6, and interferon-γ levels. Severe IFP fibrosis was associated with higher inflammatory cytokines in the synovial fluid and led to unfavorable clinical outcomes.
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| Academic Significance and Societal Importance of the Research Achievements |
関節液中の炎症性サイトカインが高い患者でIFP線維化のリスクが高いことから、そのような患者に対して、MRIによるIFP線維化の評価。IFP線維化があればリハビリ、抗炎症薬の内服、ヒアルロン酸注射など早期に介入を行い、治療成績の改善につなげる。
炎症性サイトカインがIFP線維化の発生に関わる機序の一端が明らかとなった。今後さらに詳細なメカニズムを明らかにすることでIFP線維化を抑制する治療法の開発につながると考える。
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Report
(4 results)
Research Products
(22 results)
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[Journal Article] Fibrotic changes in the infrapatellar fat pad induce new vessel formation and sensory nerve fiber endings that associate prolonged pain.2020
Author(s)
Onuma H, Tsuji K, Hoshino T, Inomata K, Udo M, Nakagawa Y, Katagiri H, Miyatake K, Watanabe T, Sekiya I, Muneta T, Koga H
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Journal Title
J Orthop Res.
Volume: In press
Issue: 6
Pages: 1296-1306
DOI
Related Report
Peer Reviewed
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[Journal Article] Long-term Evaluation of Meniscal Tissue Formation in 3-dimensional-Printed Scaffolds With Sequential Release of Connective Tissue Growth Factor and TGF-β3 in an Ovine Model2019
Author(s)
Yusuke Nakagawa, Lisa Fortier, Jeremy Mao, Chang Hun Lee, Margaret Goodale, Matthew Koff, Tyler Uppstrom, Brett Croen, Susumu Wada, Camila Carballo, Hollis Potter, Scott Rodeo
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Journal Title
The American Journal of Sports Medicine
Volume: 47
Issue: 11
Pages: 2596-2607
DOI
Related Report
Peer Reviewed
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[Journal Article] Benefit of Subcutaneous Patient Controlled Analgesia After Total Knee Arthroplasty2019
Author(s)
Yusuke Nakagawa, Toshifumi Watanabe, Yusuke Amano, Masafumi Horie, Tomomasa Nakamura, Koji Otabe, Mai Katakura, Ichiro Sekiya, Takeshi Muneta, Hideyuki Koga
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Journal Title
Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology
Volume: 18
Pages: 18-22
DOI
Related Report
Peer Reviewed / Open Access
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